Overarching Themes Research Articles

Nats’eji (healing): Examining patient and provider experiences with hospital-based Indigenous wellness services in Northwest Territories, Canada

Abstract Objective This study aimed to examine how Indigenous patients and biomedical healthcare providers understand and experience the Indigenous wellness services at a hospital in the Northwest Territories. Methods The qualitative study (May 2018–June 2022) was overseen by a regional Indigenous Community Advisory Committee. Guided by Two-Eyed Seeing and post-colonial theory, the study employed a community-engaged research design, and included two strategies for data generation: (1) interviews with Indigenous Elders, patient advocates, biomedical healthcare providers, policy makers, and hospital administrators (n = 41), and (2) iterative sharing circles with Indigenous Elders (n = 4). Data from the interviews and first sharing circle were transcribed, thematically analyzed, and presented to the sharing circle Elders for validation. Results The study revealed three overarching and related themes: (1) Elders and patient advocates emphasized that while the Indigenous wellness services at the hospital play a pivotal role connecting patients with cultural supports, the hospital was still not effectively bringing Indigenous healing practices into hospital care; (2) participants identified that structural factors (i.e., policy and governance decisions) shaped patients’ experiences with the wellness services; and (3) participants underscored that deeply rooted forces (i.e., racism, colonialism, and biomedical dominance) inhibit the integration of Indigenous healing practices. Conclusion The findings extend understandings of hospital-based Indigenous wellness services by surfacing relationships between deeply rooted forces, organizational structures, and Indigenous patients’ experiences. Altogether, they suggest that to advance care for Indigenous patients and improve the integration of Indigenous healing practices, a system-wide transformation is necessary, which includes Indigenous governance at the hospital and a recognition of the value of Indigenous healing practices.

Experiences of Informal Caregivers Caring for Individuals With Chronic Schizophrenia in Asia: A Systematic Review and Meta-Synthesis.

In Asia, many caregivers are culturally obliged to assume the role of taking care of individuals experiencing chronic schizophrenia, even as they grapple with stigma and compassion fatigue. Despite the significance of this phenomenon, the collective experiences of Asian caregivers remain poorly understood. To synthesise qualitative evidence on the experiences of informal caregivers when caring for individuals with chronic schizophrenia in Asia. A search was conducted on seven databases for studies published between 2013 and 2023. The included studies were appraised using the Critical Appraisal Skills Program tool. Data extraction was based on the Joanna Briggs Institute (JBI) Qualitative Extraction Form. The data synthesis was based on the framework by Sandelowski and Barroso. Our review included the experiences of 1345 informal caregivers from 57 included studies. The analysis yielded the overarching theme of 'Navigating Challenges, Forging Resilience'. Three themes were identified: (i) challenges in caregiving, (ii) lack of support and (iii) coping and resilience. Our findings highlighted the Asian caregivers' stressors, particularly cultural and traditional factors, a facet often overlooked in the literature. Mental healthcare practitioners must provide caregivers with comprehensive information. Anticipatory guidance is essential during the initial stages of the diagnosis. To negate geographical limitations, caregiver-training sessions can be pre-recorded and posted to online platforms. Finally, cultural and spiritual beliefs can be integrated into the treatment plans for individuals with schizophrenia in the community. Within the institutional setting, mental healthcare practitioners are encouraged to provide caregivers with comprehensible information or training in person and through written or online platforms, which can transcend geographical limitations. Anticipatory guidance is essential, especially during the initial stages of the diagnosis, when confusion and uncertainties are prevalent. Periodic home visits by mental healthcare practitioners can help ease caregivers' concerns and enhance their caregiving confidence. Finally, cultural and spiritual beliefs should be integrated into the treatment plans for individuals with schizophrenia in the community as it promotes cultural acceptability, encourages referrals to appropriate institutions and reduces the stigma of mental healthcare.

Facilitating acculturation of internationally educated nurses: A meta-synthesis of social integration strategies.

To explore the social integration strategies adopted by internationally educated nurses during acculturation and to elucidate their role in facilitating successful adaptation to their host countries. With their remarkable resilience, internationally educated nurses navigate numerous challenges in their acculturation process in the host country. While the importance of effective social integration strategies in the acculturation and subsequent retention of internationally educated nurses is well known, the specific strategies adopted by these nurses have not been extensively explored. This study aims to fill this gap with its unique and significant focus on these strategies. Eight electronic databases were searched for English articles from inception to October 2023 to ensure a comprehensive review. The quality of the included studies was appraised using the Critical Appraisal Skills Program checklist. A meta-synthesis was performed using Sandelowski and Barroso's two-step approach, and a thematic analysis was performed according to Braun and Clarke's framework. This review included experiences of 258 internationally educated nurses across 16 primary studies and has yielded the overarching theme of 'fostering a sense of belonging'. The overarching theme is supported by three themes: (1) cultivating social capital, (2) employing effective communications, and (3) engaging with the community. Internationally educated nurses' social integration is a complex process that leverages support networks, establishing connections and overcoming communication barriers. However, the most crucial element is the active involvement of the host community, which plays a significant role in internationally educated nurses' acculturation journey. This review has highlighted the importance of social integration in internationally educated nurses' acculturation journey. Interventions such as having a supportive social network, providing a customised communication programme, organising engagement activities and granting overseas home leave are practical strategies that can enhance this journey.

The Lived Experiences of Older Adults with Systemic Lupus Erythematosus: Patient Perspectives.

Little is known about perceptions of aging among individuals living with systemic lupus erythematosus (SLE). Gaining this knowledge could help to identify targets for future behavioral interventions aimed at successful aging with SLE. This qualitative study sought to elicit the lived experiences, and essence, of aging from older adults with SLE. We conducted semi-structured interviews with adults ≥65 years of age with SLE seen at a single tertiary center. Qualitative data were analyzed thematically using a phenomenological approach. We collected data on sociodemographic characteristics and disease features prior to each qualitative interview. Among 30 participants with mean age of 71.3 years and mean SLE duration of 26.3 years (range 5 to 62 years), four overarching themes emerged to describe the essence of aging with SLE: SLE and comorbid conditions, cumulative impact of SLE symptoms, SLE disease trajectory, and self-perceptions of aging. Older adults with SLE shared variable aging experiences, including perspectives on multimorbidity and disease trajectory and self-perceptions of aging. We identified both positive and negative self-perceptions of aging, often informed by participants' lived experiences of cumulative impact of SLE symptoms and SLE disease trajectory and underscoring the diversity of their experiences. Understanding self-perceptions of aging in this population could inform development of evidence-based strategies to empower older adults with SLE to harness their positivity and resilience and thus improve health-related outcomes, including health-related quality of life.

"Another tool for the sexual health toolkit": U.S. health care provider knowledge and attitudes about doxycycline post-exposure prophylaxis (doxy-PEP) to prevent bacterial sexually transmitted infections among men who have sex with men.

Doxycycline post-exposure prophylaxis (doxy-PEP) reduces chlamydia, gonorrhea, and syphilis infections among men who have sex with men (MSM) and transwomen (TW). Perspectives of health care providers (HCPs) regarding doxy-PEP can inform implementation efforts. From August 2022 to January 2023, HCPs were recruited from 13 cities with high sexually transmitted infection (STI) rates for semi-structured, in-depth interviews about their awareness of and attitudes towards doxy-PEP for STI prevention. HCPs were purposively sampled to include people with experience prescribing PrEP and provision of care to MSM. Interviews were conducted virtually via Zoom. Transcripts and debrief reports were analyzed using a directed content analysis approach to explore knowledge, attitudes, and beliefs about doxy-PEP. Among 30 HCPs, almost half (47%) were between 31-40 years of age, 53% identified as male, and 47% reported their sexual orientation as gay or queer. Half (53%) of participants practiced in the South, 43% had >100 MSM in their clinic panel, and 17% had previously prescribed doxy-PEP. We identified four overarching themes: 1) HCPs expressed positive attitudes towards doxy-PEP; 2) antimicrobial resistance concerns limit enthusiasm for some HCPs; 3) additional data about the long-term safety of doxy-PEP would improve their confidence; and 4) development of guidelines would facilitate the prescription of doxy-PEP, including eligibility, dosing instructions, and treatment management. HCPs were motivated to prescribe doxy-PEP with almost 20% already having prescribed it. Guidelines and data about long-term safety, especially antimicrobial resistance, would facilitate introduction of doxy-PEP into clinical practice.

Exploring risk and resilience in school environments for students in kinship care

ABSTRACT Kinship care is provided by members of a child’s extended family or friend network when they can no longer live with their parents. This study explores risk and resilience in UK school environments for students in kinship care. Eight professionals experienced in working with students in kinship care and their schools took part in individual, semi-structured interviews. Interviews focussed on kinship students’ needs and how professionals perceive schools respond to those needs. Reflexive thematic analysis generated over-arching themes indicating that: children in kinship care have multiple needs and are looked after by kinship carers who find themselves “between a rock and a hard place”; in some schools kinship care is “under the radar”; other schools respond to kinship families with the attitude of “the apple doesn’t fall far from the tree”; and in some schools kinship care is “on the agenda”. A model is presented that integrates risk and protective factors within schools, generated from this study, with risk and protective factors for kinship students within families, identified by previous literature. Implications for educational psychology (EP) practice are presented, and further research needs discussed.

Cancer prevention for homeless people: Qualitative evaluation of the Health Navigator Model

Abstract Background People experiencing homelessness (PEH) face significant barriers when accessing cancer preventive services. The Health Navigator Model (HNM) seeks to address these challenges by improving access and engagement with cancer preventive care through tailored navigation services. This study aimed to explore PEH’s and health navigators’ experiences with the HNM. Methods This qualitative evaluation involved semi-structured interviews with a total of 61 PEH receiving the HNM intervention and 11 health navigators across four pilot sites in Austria, Greece, Spain, and the UK. Data were analyzed thematically using a cross-national coding framework. Results Following overarching themes were identified: (1) State of health and perception of health of PEH; (2) Experiences and understanding of cancer prevention; (3) Perceived effects of the Health Navigation intervention; (4) Navigators’ experiences with the implementation of the Health Navigation intervention; and (5) Effects of the Health Navigation intervention from the navigator perspective and sustainability of the intervention. Participants reported a general lack of access to healthcare services and low cancer prevention literacy. The HNM intervention led to increased engagement in cancer prevention activities, such as screenings, facilitated by the personalized support from health navigators. Navigators played a crucial role in bridging the gap between PEH and healthcare systems, though challenges such as mistrust and logistical barriers persisted. Conclusions The HNM has shown potential in enhancing cancer preventive care access for PEH by providing personalized guidance and support. The navigators’ role was pivotal in overcoming systemic and individual barriers, suggesting the need for integrated services that cater specifically to PEH. Future implementations should consider continuous training for navigators and further integration into local health systems to expand the benefits of the intervention. Key messages • The Health Navigator Model effectively enhanced cancer prevention engagement among people experiencing homelessness and empowered them through tailored and person-centered support. • Health navigators bridged healthcare gaps for people experiencing homelessness, improving their access to cancer preventive care services in their local settings.

How could you help me? Children's voices on violence in child welfare files: A thematic analysis

BackgroundA significant number of children experience violence, frequently from parents or other caregivers. Yet, many of these children lack access to community support, largely due to the challenges they face in disclosing abuse. Even when children do disclose abuse, it does not necessarily lead to their receiving the help needed. Recognizing children as epistemic subjects is essential both for ensuring their access to adequate support and for advancing knowledge about child abuse. ObjectiveThis study aimed to explore children's voices on violence in child welfare files to enhance our understanding of their experiences of violence. Participants and settingThe sample consisted of 120 children who provided abuse information in Swedish child welfare investigations into physical and sexual abuse. MethodData were collected from child welfare files and analyzed qualitatively using thematic analysis. ResultsSix themes were identified—acts of violence, emotions, context, disclosure, agency, and abuse dynamics—all of which informed the overarching theme: Children's voices highlight violence as a specific problem characterized by power and control dynamics that significantly impact their lives. ConclusionsThe collective findings indicate that mechanisms of violence extend beyond physical acts, emphasizing the need for Child Welfare Services (CWS) to recognize child abuse as a distinct issue characterized by dynamics of power and control. These dynamics significantly affect children's health and their capacity to assert their own interests. Failure to address these aspects risks underestimating the severity of the violence and impeding the provision of adequate support.

29 A call for action - The lived experiences of caregivers of children diagnosed with Fetal Alcohol Spectrum Disorder during assessment and following diagnosis

Abstract Background Individuals diagnosed with Fetal Alcohol Spectrum Disorder (FASD) have a heterogeneous range of neurodevelopmental impairments with lifelong impacts on functioning. In Canada, a FASD diagnosis is made through a multidisciplinary team assessment, using the 2015 Canadian FASD Diagnostic Guidelines. Studies show that early diagnosis and intervention reduces secondary FASD related disabilities and improves outcomes in adulthood. However, little has been published about accessibility of services and intervention for children diagnosed with FASD in Canada. Objectives The current study explores the lived experiences of caregivers in (1) undergoing a diagnostic assessment for FASD and (2) obtaining services and interventions for their child in the first two years following diagnosis. Using a qualitative approach, the study aimed to identify strengths and gaps in the system with respect to supporting Canadian children with FASD and their families. Design/Methods Seventy one (71) children were diagnosed with FASD/At Risk for FASD over a one year period at a tertiary Developmental Assessment Center in Canada. Through non-random convenience sampling, 18 caregivers (the child’s legal guardians: 1 biological parent, 9 adoptive parents, 6 family guardians and 2 social workers) consented to participate in semi-structured interviews. Interviews explored caregiver experiences with the FASD diagnostic process as well as access to supports and intervention services after diagnosis. Interviews were transcribed and analyzed using reflexive thematic analysis. Results The following overarching themes were identified: (1) The journey of raising a child with FASD is overwhelming for caregivers; (2) The assessment process was both affirming and disheartening for caregivers; (3) There are significant, multi-level, systemic barriers to accessing supports for children with FASD, and their caregivers; (4) Equity deserving caregivers and their children are particularly vulnerable to falling through the cracks of the medical, educational, and social systems. Within each theme, subthemes further highlight protective factors and specific gaps in the system in supporting children and their families with respect to early intervention, educational/vocational, community and family support. Conclusion Children newly diagnosed with FASD are falling through the cracks of our healthcare system. There are clear disparities in the accessibility of intervention and support for children with developmental differences, even with a diagnosis. Wrap around support is needed for children with FASD and their families, as soon as functional impairments are recognized. A formal funding and support system, based on function, is essential for all children with developmental differences - including children with FASD.

Experiences across a genetic screening and testing programme pathway: a qualitative study of mammogram patient perspectives

BackgroundPopulation-based genetic screening and testing programmes have substantial potential to improve cancer-related outcomes through early detection and cancer prevention. Yet, genetic testing for cancer risk remains largely underused. This study...

Intra-articular corticosteroid injections for osteoarthritis: A qualitative study of patients' and clinicians' experiences.

Osteoarthritis is a leading cause of joint pain and disability. Intra-articular corticosteroid injections (IACs) are often used in primary care once other recommended treatments have failed. Evidence shows that IACs provide short-term relief of osteoarthritis symptoms, yet little is known about patients' and primary care clinicians' experiences and beliefs about their use. We explored patients' and primary care clinicians' views about IACs, including the benefits, disadvantages, perceived risks of treatment, when they are used, and factors that affect decision-making. We conducted individual interviews with patients and primary care clinicians and used inductive thematic analysis to investigate their views and experiences of intra-articular corticosteroid injections for osteoarthritis (IACs). We interviewed 38 patients and 19 primary care clinicians. We identified 6 patient themes: variation in access; awareness of IACs; views of risk and trust; effectiveness of IACs; variation in onset and effect duration; and an alternative to undesirable treatments. In the interviews with clinicians, we identified an overarching theme of caution and competence, which included eight subthemes: confidence and (dis)comfort with practical procedures; risk of adverse outcomes; training; uncertainty about evidence and guidelines; technical uncertainties; IACs use on the osteoarthritis pathway; perceived benefits and impacts of IACs; and the possibility of placebo. Patients and clinicians valued IACs' potential to relieve symptoms and improve quality of life. Variability in patients' access to treatment appears related to clinicians' confidence in delivering injections and their concerns about the evidence base. Variation in dose frequency and timing reflect clinicians' uncertainty about current guidance. Despite variation in effectiveness patients preferred IACs to other forms of pain medication and to delay or avoid surgery. IACs were mostly used as an adjunct treatment before surgery was offered. These findings can inform further research into the effectiveness of IACs and improvements in information and guidance.

Towards a responsible gaming ecosystem: a call to action

Purpose Drawing from transformative service research (TSR) and service ecosystem perspectives, the author seeks to provide multi-level insights into gaming service systems and call to action how this knowledge can contribute to cultivating socially responsible gaming by addressing the following research questions: What insights from service ecosystem and TSR literature can help optimise value co-creation and cultivate socially responsible practices in digital gaming services? What future research directions could advance the understanding of digital gaming services and their potential to develop a responsible gaming ecosystem that balances social well-being with commercial success? Design/methodology/approach Adopting a conceptual approach of theory synthesis and adaptation, the author discusses four overarching themes alongside key research gaps and directions crucial for understanding the dynamics of gaming ecosystem. Findings The central themes – “Exploring individuals as game service consumers”, “Gaming service exchange dynamics among meso-level stakeholders”, “A macro lens to gaming service ecosystem” and “The complexities of multi-actor dynamics and interdependencies” – shed light on how responsible services can be fostered. Research limitations/implications Given the absence of a well-defined scope for understanding responsible gaming, future research should develop a typology to capture its multifaceted aspects. Expanding beyond micro-level analysis, conducting consultation interviews with industry practitioners and policymakers can contribute insights into promoting responsible gaming services. Social implications The author offers insights for the game players, designers and developers, service providers and policymakers to promote a healthy gaming culture. Originality/value Through this research, the author advances the understanding of gaming as a service by illuminating value co-creation and co-destruction within an interconnected gaming service ecosystem through the lens of TSR. Such understanding empowers businesses to prioritise consumer welfare in their decision-making and practices.

Examining the Role of School Librarians in Teaching Young Children to Detect and Avoid Misinformation

This study investigates the imperative for implementing an informational literacy curriculum in K-5 school libraries to equip students with essential skills for detecting and avoiding misinformation. Using a mixed-methods approach, data were collected from 141 school librarians across the United States. Quantitative analysis revealed significant gaps in information literacy instruction frequency and resource availability. Qualitative analysis identified four overarching themes: Awareness, Identification, Resources, and Risks/Harm. Together these results highlight the pressing need for curriculum development in this area, emphasizing critical thinking skills through age-appropriate resources. The findings underscore the importance of advocating for dedicated instructional time and the creation of tailored teaching materials to empower students as discerning consumers and responsible citizens. This research contributes valuable insights to the fields of school libraries and information literacy, informing future initiatives aimed at enhancing students' ability to navigate the complexities of the digital age.

Training an infectious disease unit in palliative care during and post COVID-19: a qualitative longitudinal study.

To understand palliative care needs and their changes perceived by health professionals (HPs) of the Infectious Diseases Unit who participated in palliative care (PC) intensive training during the pandemic and behind/during the pandemic and one year after the outbreak. A longitudinal qualitative study. Thematic analysis and meaning shift were two months after training to one year. This specific thematic approach enabled the researchers to fully understand the experiences of the HPs after they participated in the intensive PC training program during the pandemic. Participant validation meeting with the ward's staff one year after the end of the course was performed. The two last validation meetings were used as a triangulation source to plan the new education projects. From March 9 to 28, 2020, the Palliative Care Services (PCS) developed intensive experiential training. Thirty-one HPs of the Infectious Diseases Unit (physicians and nurses) who were facing the COVID-19 emergency participated in the training. We conducted eight semi-structured interviews with HPs who participated in intensive training during the first wave of the pandemic (T0), two months (T1) after training and after one year (T2), during the second wave. Two validation meetings were performed as suggested by the best practices in medical education. Twenty-two infectious disease staff members participated, 8 physicians and 14 nurses. Our data show a meaning shift on five overarching themes (defined within the sub-themes): (1) Recognizing patients' palliative care needs; (2) Responses to palliative care needs; (3) Increasing attention to intervention and care choices; (4) The suffering of health professionals; (5) Training evaluations and future expectations. At the end of Pandemic period, new training needs and acquisition have emerged. Palliative care needs changed over time: the COVID-19 themes are now far from their perception, and somehow the skills acquired during the intensive training are less present. The pandemic led to a rapid acquisition of competencies and changes in the professionals' behaviors, maintenance of professionals' knowledge and competencies at two months and one year. COVID has improved relationships and increased interactions with the infectious world but that it has not been enough. The integration between PC and Infectious world needs models of integration to implement.

Building locally anchored implementation science capacity: the case of the adolescent HIV implementation science alliance-supported local iS alliances.

The Fogarty International Center-led Adolescent HIV Implementation Science Alliance (AHISA) supports region-/country-specific implementation science (IS) alliances that build collaborations between research, policy, and program partners that respond to local implementation challenges. AHISA supported the development of seven locally-led IS alliances: five country-specific (i.e., Kenya, South Africa, Tanzania, Uganda, and Zambia), one in Central and West Africa, and one with youth researchers. This article outlines the aims, activities, and outcomes of local alliances, demonstrating how they enhance sustainable IS activities to address local challenges. We conducted a desk review of each alliance's funding applications, reports, and data from the initial findings of a larger AHISA evaluation. The review analyzes common approaches, highlights their local relevance, and summarizes initial outcomes. The local alliances have a common goal: to expand implementation of successful interventions to improve adolescent HIV. We identified four overarching themes across the local alliances' activities: capacity building, priority setting, stakeholder engagement, and knowledge dissemination. Research capacity building activities include long-term mentorship between junior and senior researchers and short-term training for non-research partners. Setting priorities with members identifies local research needs and streamlines activities. Alliances incorporate substantial engagement between partners, particularly youth, who may serve as leaders and co-create activities. Dissemination shares activities and results broadly. Local IS alliances play a key role in building sustainable IS learning and collaboration platforms, enabling improved uptake of evidence into policy and programs, increased IS research capacity, and shared approaches to addressing implementation challenges.

Navigating post-ICU care: understanding family members’ experiences - a qualitative study

ABSTRACT Background: Comprehending and addressing the needs of caregivers during the post-intensive care unit (ICU) phase is vital for establishing sustainable support systems and improving the overall quality of life (QoL) for both patients and caregivers. Objective: To explore the experiences of family members (FMs) caring for loved ones three-months after ICU discharge and their related QoL. Methods and measures: A qualitative, descriptive research was conducted. Participants were recruited from two general ICUs in an Italian Academic Hospital. Data collection lasted two months and was performed with telephonic interviews led by ICU nurses. Thematic analysis was conducted using a hybrid approach, incorporating both deductive and inductive coding strategies. This process has been facilitated by Atlas.ti software. Results: Twenty-four FMs participated, representing a diverse range of familial relationships with the patients. Thematic analysis revealed four overarching themes: 1) QoL underwent transformations; 2) Positive emotions laden with significance; 3) Supporting role taken on by a caregiver; and 4) Life’s transience through the meaning-making of the illness event. These themes highlighted the multifaceted nature of the caregiving experience. Conclusions: This study provides valuable insights into the challenges and dynamics faced by FMs following ICU discharge. Findings underscore the importance of addressing environmental challenges, cultivating positive emotions, and strengthening caregiver-patient relationships to enhance the caregiving experience and promote overall QoL. FMs can adapt their personal concepts and reach their full potential by learning to coexist with the demanding role of caregiver and achieve a new level of resilience and fulfillment.

Veteran suicide thoughts and attempts during the transition from military service to civilian life: Qualitative insights

A rapidly growing literature highlights a critical need for targeted suicide prevention and risk mitigation strategies for veterans navigating the military-to-civilian transition. Although various risk correlates of suicidal thoughts and behavior among transitioning veterans have been identified, how and why these correlates occur and interact to affect suicidality remains unclear. Guided by the 3 Step Theory of Suicide, 10 recently discharged United States military veterans with a history of post-discharge suicide thoughts, urges, or behaviors completed interviews on the military-to-civilian transition and suicidal thoughts and behaviors occurring during this time. Thematic analysis highlighted an overarching theme of transition whiplash comprising four subthemes: unpreparedness, economic vulnerability, identity disruption, and social alienation. Veterans’ recommendations for improving suicide-prevention efforts included providing a primary contact to provide personalized support and guidance throughout transition and increasing accessibility of peer support. Results provide nuanced insight into experiences that may underlie suicide risk during the military-to-civilian transition.

“What you say in the lab, stays in the lab”: A reflexive thematic analysis of current challenges and future directions of digital forensic investigations in the UK

Despite digital evidence nowadays playing a major role in criminal investigations and being intrinsic to almost every criminal trial, research in digital forensics (DF) and national approaches to digital evidence in relation to investigating officers and court personnel remain almost non-existent. This research seeks to remedy this issue by qualitatively examining the accounts and experiences of 16 digital forensic investigators (DFIs) in England and Wales who took part in semi-structured interviews. We analyzed the data using a reflexive thematic analysis and identified four overarching themes: (i) Navigating tensions with investigating officers (that has a subtheme of ‘Tensions with legal professionals and challenges navigating court theatrics’) (ii) The psychological, emotional, and existential challenges confronted by DFIs; (iii) Identifying the potential and pitfalls of automation and AI in DF and (iv) The centrality of academia in the advancement of DF (that has a subtheme of ‘Validation of tools as a crucial step in digital forensics’). These new findings reveal that DFIs encounter significant demands to perform well and are continuously overburdened while juggling many roles. This research serves as a pivotal starting point for broader discussions.

Exploring the Adoption Phenomenon of Artificial Intelligence by Doctoral Students Within Doctoral Education

The adoption of artificial intelligence (AI) in academia is an emerging field of interest. However, there is scant literature that explores the phenomenon of AI adoption by graduate students in doctoral education. This study employs collaborative autoethnography to explore and better understand the nuances of how doctoral students experience AI technologies within academic pursuits. A critical analysis of data revealed that the collective researcher-participant experiences offered the primary overarching theme of adoption strategy, with four distinct subthemes: adoption fear, adoption resistance, adoption feasibility, and adoption ethics. The findings suggest a balanced approach to AI adoption depends on the development of comprehensive strategies that are informed by a deep understanding of both the technological capabilities and the human factors involved. We urge both doctoral students and educators involved in doctoral programs to think critically about these identified themes. For doctoral students, this analysis offers valuable insights into challenges associated with integrating AI technologies into formal learning environments, potentially enhancing a management strategy for their doctoral studies. Educators tasked with integrating and evaluating AI technologies for doctoral coursework may develop a deeper understanding of the challenges their students may encounter during the adoption process.

Patient and provider perceptions of the benefits and limitations of implementing ePRO-driven remote symptom monitoring into real-world cancer care settings.

325 Background: Remote symptom monitoring (RSM) utilizes electronic patient-reported outcomes (ePROs) to facilitate the monitoring and management of treatment-related symptoms outside of traditional healthcare appointment settings. Research suggests benefits surrounding the implementation of RSM; however, there is a literature gap regarding patient and provider perceptions of its implemented use. Methods: This qualitative study included patients and providers from the University of Alabama at Birmingham (UAB) and the Mitchell Cancer Institute (MCI) in Mobile, Alabama, who participated in semi-structured interviews aimed at gaining insight into the experiences of and perceptions surrounding RSM utilization. Interviews occurred over the phone, via digital videoconference, or in person, and were transcribed and inductively coded using NVivo software alongside a constant comparative method to establish a grounded coding schema. Results: Forty patients (20 UAB; 20 MCI) and 30 oncology providers (16 UAB; 14 MCI) identified 25 benefits across 3 overarching themes. Patients and providers found RSM Facilitated Proactive Management enabling early symptom identification and intervention, which helped to reduce symptom burden. Both groups also noticed RSM Improved Therapeutic Alliance, by fostering the relationship between the patient and their care team and enhancing the patient’s sense of safety and security through continued and sincere communication. Patients and providers also discussed how RSM Promoted Self-Efficacy and Management among Patients by allowing patients to feel involved and in control of their care, while giving them an inclination to be active members in their care. Providers felt that more active patient involvement in care contributed to a more accurate and thorough reporting of symptoms. Patients and providers also noted drawbacks regarding RSM, including lack of need in cases of no or mild symptoms. Conclusions: Patients and providers recognized the impact RSM had on patient care during cancer treatment. However, given some of the perceived limitations, patient and provider evaluations should continue to ensure successful implementation in future clinical trials. Clinical trial information: NCT04809740 .